M2Z COMPLIANCE SOLUTIONS
Nationwide Drug Testing & DOT Compliance Solutions
Registered C/TPA | FMCSA | HIPAA-Compliant
(888) 282-2279
info@m2zcompliance.com
1400 Buford Hwy NE, F-4
Sugar Hill, GA 30518
GET STARTED — NEW CLIENT INQUIRY & INTAKE FORM
Complete this form to request services or ask questions. Our team responds within
1 business day
. For urgent RTD situations or
driver violations, call us directly: (888) 282-2279.
* Required field
01 YOUR CONTACT INFORMATION
First Name *
*
First Name
Last Name
Last Name *
*
First Name
Last Name
Phone Number *
*
Format: (000) 000-0000.
Email Address *
*
example@example.com
Company / Organization
State *
*
02 I AM A... (Select one)
I AM A...
CDL Driver / Owner-Operator Navigating RTD or DOT compliance
Employer / Fleet Manager Managing drivers and testing programs
Trucking Company Need full DOT compliance solution
Healthcare Provider / Treatment Ctr Clinical drug testing programs
CDL School Student testing & compliance
Trucking Recruiter Placing CDL drivers with carriers
Other / Not Sure I have questions - please contact me
03 SERVICES I'M INTERESTED IN (Check all that apply)
Select as many as apply. Not sure? Check the last box and describe your situation in Section 6.
SERVICES I'M INTERESTED IN
Return-to-Duty (RTD) Complete Package - $299 Get out of prohibited status. Drug test included.
DOT Urine Drug Test - $85 5-panel FMCSA-compliant. Nationwide.
DOT Breath Alcohol Test (BAT) - $85 Standalone. RTD client add-on: $75.
DOT Drug + Alcohol Combo - $145 Both tests together. Save $25.
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DOT Physical Exam - $125 Required CDL medical certificate. Member rate: $95-$99.
Non-DOT Drug Test (5-panel) - $75 Pre-employment or personal use. Nationwide.
Hair Follicle 5-Panel- $155 90-day detection. Volume rate: $140 (5+/mo).
Hair Follicle 10-Panel- $190 Extended screen. Volume rate: $170 (5+/mo).
Solo Owner-Operator Consortium - $99/yr Random pool + Clearinghouse + support.
Small Fleet Consortium (2-20 drivers) $199-$399/yr. Flat annual fee per fleet size.
Growing Fleet Consortium (21-50 drivers) - $599/yr Full random pool management. Annual.
DQ File Management Add-On We build & maintain your driver qualification files.
Employer RTD Management Program - $175/driver Full case management: violation to green checkmark.
Follow-Up Compliance Program - $49/mo Post-RTD follow-up tracking. Driver pays directly.
Driver Compliance Binder - $25-$35 Pre-organized CDL compliance binder per driver.
Not Sure / Other Tell us your situation in Section 6.
04 FOR EMPLOYERS & FLEET MANAGERS (Skip if driver/individual)
How many CDL drivers does your company have?
1 (Solo Owner-Operator)
2-5 Drivers
6-10 Drivers
11-20 Drivers
21-50 Drivers
50+ Drivers
Do you currently have a C/TPA managing your DOT compliance program?
Yes—looking to switch
No—setting up now
Not sure
Do you currently have a driver in prohibited status or going through RTD?
Yes—need help now
No
Not sure
Are you interested in the M2Z Driver Retention & RTD Repayment Program? (M2Z manages the RTD case and helps you recover costs from the driver.)
Yes - tell me more
No
Not sure
05 FOR CDL DRIVERS (Skip if employer/organization)
Where are you in the RTD process right now?
Just received a violation - not started yet
In the SAP process (Steps 1-4)
SAP cleared me - ready for my RTD test
Already did RTD - need follow-up management
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Driving but need consortium enrollment
Not sure - need guidance
CDL License Number
State CDL is Registered In
Have you been working with a Substance Abuse Professional (SAP)?
Yes - SAP name below
No - need a referral
Not sure what a SAP is
SAP's Full Name
SAP's Phone or Email
06 HOW & WHEN TO REACH YOU
Preferred Contact Method:
Phone Call
Text / SMS
Email
Any Method
Best Time to Reach You:
Morning 9am-12pm
Afternoon 12pm-5pm
Evening 5pm-7pm
Anytime
How did you hear about M2Z?
Google Search
Social Media
Referral / Word of Mouth
SAP Referral
CDL School
Recruiter / Employer
07 TELL US MORE (Optional but helpful)
Additional Details - Share anything that helps us prepare for your call
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Authorization & Consent: By submitting this form I authorize M2Z Compliance Solutions to contact me regarding my inquiry via phone, text, or email. Message and data rates may apply. Submission does not constitute enrollment in any service. All information is confidential and handled per our Privacy Policy and HIPAA standards. I understand that all service sales are final and non-refundable per the M2Z Refund Policy.
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*
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FOR OFFICE USE ONLY
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Date Received
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Case / File #
Follow-Up Date
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Service(s) Confirmed
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Internal Notes
M2Z Compliance Solutions | HIPAA-Compliant | Registered C/TPA | All 50 States | All information is confidential (888) 282-2279 | info@m2zcompliance.com | m2zcompliancesolutions.com
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